How do quality improvement (QI) tools and methods contribute to healthcare improvement?

50 %
50 %
Information about How do quality improvement (QI) tools and methods contribute to...

Published on June 21, 2013

Author: ckforum

Source: slideshare.net

Description

2013 Canadian Knowledge Mobilization Forum
Cathy Howe
NIHR CLAHRC for Northwest London

How do quality improvement(QI) tools and methodscontribute to healthcareimprovement?Cathy Howe, Julie Reed, Derek BellNIHR CLAHRC for Northwest London

CLAHRC NWL ApproachQualityImprovementQuality Improvement MethodsPatient and PublicInvolvementEngaging Patients and StaffResearchRigorous Design and Use ofDataEducationTraining, Support andCollaborationA collision of different worlds…NIHR CLAHRCFor Northwest LondonHealth OutcomesPatient ExperienceImprove health outcomes and patient experience through delivery ofclinically effective care.Primary aim:4 Rounds: 21 Projectsover 55 Sites engagingover 500 NHS staffsystematic approach

CLAHRC NWL AchievementsBeneficial impacts on care quality, outcomes, experience and costs• COPD discharge care bundle:– Improved compliance with „best care‟ (from 0% baseline - 70%)– reduced length of stay (e.g. by 2.5 days)– costs savings (e.g. estimated at £123,410/year)• Medicines Management:– ADR identification (e.g. 70% potential ADR)– medication reduction (e.g. 52% meds)– cost avoidance (e.g. estimated net £145,000/yr)– co-designed “My Medication Passport” (paper & app, c.9,000 copies)• Diabetes Improvement through Peer Led Education (DIMPLE):– Built capacity: 31 “community champions‟, 6 peer educators and 9 peer mentors– engaged over 9,182 people through 352 events inc BME groups,– Social return on investment estimated at £11 for every £1 invested.Demonstrated Patient & Public Engagement & Involvement benefitsInclude (3 examples):

Conceptual Frameworkfor delivering improvement in healthcareAct scientificallyandpragmaticallyEngage andempowerEmbraceComplexitySupport for longterm successUnderstand and utilise existing knowledgeIterative DevelopmentCapture and produce new knowledgeActive engagementFacilitate dialogueFreedom to act and willingness to learnUnderstand services and processesUnderstand variationIdentify and act on systemic issuesProvide headroom and resourcesPolitical and Strategic AlignmentInvest in continual improvementValuesPrinciples

Contribution of QI tools and methods : The CLAHRC NWL approachResources/ Funding£100k or £50k to develop or ‘roll-out’ projects matched funded byNHS and/or industry partners..Model for ImprovementThree questions and rapid-cycle smalltests of change.Measurement for ImprovementA ‘few key weekly measures’ to show progress using run charts and automated SPC charts.Representative Team (Centre)Clinical lead, project manager, information lead andexecutive sponsor, plus others including patients.Process MappingRepresentation of activities andbranching points in a care ordata process.Patient & Public InvolvementPatient advisors, digital stories, focus groups…Action Effect MethodA facilitated approach torepresent the ‘theory of change’including a patient-focusedaim, contributing factors, andideas for interventions.Outcome MeasurementOne or two measures to show impact ofthe work on outcomes, qualitative orquantitative.ReviewsTwo-way formative 6 monthreviews exploring how teamsuse and engage with QI tools.Sustainability ModelNHS III Sustainability Model toidentify and address factorsthat affect sustainability.Stakeholder MappingTwo-by-two matrix to identify keystakeholders interest and influenceplus management plan.

Act Scientifically & Pragmatically: Utilise existing knowledge.Model forImprovementProcessMappingAction EffectMethod

Act Scientifically & Pragmatically: Iterative Development.Model forImprovementMeasurement for ImprovementRepresentative Team(Centre)

Act Scientifically & Pragmatically: Capture & produce new knowledge.Model forImprovementMeasurement for ImprovementRepresentative Team(Centre)ProcessMappingPPE/IAction EffectMethodOutcomeMeasurementReviewsSustainabilityModelStakeholderMapping

Contribution of QI tools : Act Scientifically & Pragmatically.Model forImprovementMeasurement for ImprovementRepresentative Team(Centre)ProcessMappingPPE/IAction EffectMethodOutcomeMeasurementReviewsSustainabilityModelStakeholderMapping

Contribution of QI tools : Engage & Empower.Model forImprovementMeasurement for ImprovementRepresentative Team(Centre)ProcessMappingPPE/IAction EffectMethodOutcomeMeasurementReviewsSustainabilityModelStakeholderMappingFinancial Support

Contribution of QI tools : Embrace Complexity.Model forImprovementMeasurement for ImprovementRepresentative Team(Centre)ProcessMappingPPE/IAction EffectMethodOutcomeMeasurementReviewsSustainabilityModelStakeholderMapping

Contribution of QI tools : Support Long Term Success.Model forImprovementMeasurement for ImprovementRepresentative Team(Centre)ProcessMappingPPE/IAction EffectMethodOutcomeMeasurementReviewsSustainabilityModelFinancial Support

QI tools contribution• All tools make social and technicalcontributions• All tools contribute to two or more values• Most tools contribute to most values• Tools contribute differently to all values –but exactly how, is still to be explained• No ‘super-tool’ or subset of ‘super-tools’

QI tools in practiceModel for Improvement Sustainability Model Driver Diagram Measuring for Improvement Process Mapping Stakeholder Engagement PPI Dissemination of Learning Project MedianRound 11 1 1 2 3 1 2 2 5 22 3 2 2 3 1 2 5 5 2.53 1 1 2 2 0 2 0 6 1.54 5 1 2 2 1 2 5 6 25 5 1 2 2 6 5 2 6 3.56 3 1 2 6 6 2 2 6 2.5Median 3.0 1.0 2.0 2.5 1.0 2.0 2.0 6.0Round 21 5 1 5 3 5 6 5 5 52 5 6 5 3 6 3 6 5 53 5 2 2 4 3 5 3 2 34 3 2 2 2 2 2 2 5 25 1 2 2 2 5 3 2 2 26 5 2 2 3 6 2 2 5 2.57 3 2 2 3 5 3 2 5 38 3 2 2 1 0 2 3 5 29 1 1 2 0 0 1 2 6 110 2 2 2 1 0 1 2 1 1.511 2 1 2 1 0 2 3 6 212 5 3 2 0 0 3 2 5 2.513 3 1 2 2 0 2 2 5 214 5 1 2 5 3 3 2 6 315 3 1 5 5 3 3 5 5 416 5 0 2 5 0 2 2 6 217 3 1 2 0 0 1 2 5 1.5Median 3.0 2.0 2.0 2.0 2.0 2.0 2.0 5.0Round 31 6 5 6 6 6 5 5 5 5.52 5 0 6 0 6 2 2 5 3.53 1 3 5 1 6 2 5 5 44 3 3 5 1 6 2 6 5 45 1 3 5 0 6 2 5 5 46 4 3 5 5 5 5 2 2 4.57 1 0 1 2 0 2 2 5 1.58 3 1 2 2 3 5 2 0 29 5 0 5 5 6 5 5 5 510 5 3 5 5 6 2 2 5 511 6 0 2 0 6 5 2 5 3.512 5 3 6 5 6 4 5 5 513 3 0 5 3 6 6 5 2 414 5 0 5 6 1 6 6 5 515 5 3 5 5 6 6 6 5 516 5 2 6 5 4 2 2 6 4.517 5 3 5 3 6 2 2 5 418 3 3 5 5 6 5 2 3 419 4 0 5 3 6 5 5 2 4.520 4 3 5 5 4 6 5 5 5Median 4.5 3.0 5.0 4.0 6.0 5.0 5.0 5.0• The degree of engagement with each of the QI tools andmethods varied within and across projects.• More projects engaged with more methods in each round.

NIHR CLAHRCfor Northwest LondonFind us at…W: www.clahrc-northwestlondon.nihr.ac.uk/homeE: clahrc.nwl@imperial.ac.ukT: @CLAHRC_NWLFind me at…W: www.cathyhowe.netE: c.howe@imperial.ac.ukT: @cathgreenhalgh

Add a comment

Related pages

Quality Improvement - Health Resources and Services ...

Quality improvement (QI) ... an organization can often visualize opportunities for improvement. The process mapping tool may also be ... How do QI ...
Read more

Chapter 11 QUALITY IMPROVEMENT (QI) - WHO

Chapter 11 QUALITY IMPROVEMENT (QI) ... staff can use the tools and methods of quality improvement to focus on the ... what QI is about and how to do ...
Read more

Quality Improvement Methods & Tools

Quality Improvement Methods & Tools ... Overview of Quality Improvement (QI) ... Continuous Improvement Act Do Check/ Study
Read more

CDC - Quality Improvement Methods and Tools - NPHII ...

The National Public Health Improvement Initiative ... Quality Improvement Methods and Tools. ... Described Quality Improvement (QI)
Read more

Take the Lead on Healthcare Quality Improvement - Case ...

Take the Lead on Healthcare Quality Improvement ... in healthcare and how you can contribute by ... these methods, you will add powerful QI tools to ...
Read more

Quality Improvement Guide - Health Quality Ontario, 2012

QI Methods & Tools ... 1.1 WHAT IS QUALITY IN HEALTHCARE? ... Quality Improvement Guide 3 A successful QI project team uses structured improvement ...
Read more

Quality Improvement - Health Resources and Services ...

Clinical Quality Measures; Quality Improvement ... Quality Improvement. Part 1: Quality Improvement (QI) ... QI is a method for continuously finding ...
Read more

Quality Improvement Principles, Methods and Tools

Quality Improvement Principles, Methods and Tools ... MCPP Healthcare Consulting QI Principles, Methods ... • Apply selected Quality Improvement tools ...
Read more

Basics of Quality Improvement in Health Care

CONCISE REVIEW FOR CLINICIANS Basics of Quality Improvement in Health Care PRATHIBHA VARKEY, MBBS, MPH; M. KATHERINE RELLER, RN, BSN, CPHQ, CQM; AND ROGER ...
Read more